2018-02-22T10:35:04Zhttp://ijp.mums.ac.ir/?_action=export&rf=summon&issue=9562016-04-0110.22038International Journal of Pediatricsijp ; Int J Pediatr2345-50472345-5047201644Prediction Value of CRIB-II in Outcome of Preterm and Low Birth Weight Infants: a Prospective Cohort StudyMohammadHeidarzadehFatemehGhorbaniSaeedDastgiriBackground: One of the most common methods of identifying mortality risk is the Clinical Risk Index for Babies scoring system (CRIB- II). The aim of this study was assessing the value of CRIB- II in predicting mortality risk in preterm and low birth weight infants in East Azerbaijan- Iran. Materials and Methods: This prospective cohort study was carried out in 2013-2014 during 6 months in NICUs of Alzahra, Taleqani and Children hospitals of Tabriz-Iran. All infants ≤ 32 weeks’ gestational age or ≤ 1500gr birth weight were included in the study using consecutive method. After calculating CRIB- II score, the infants were followed up at 3 months of age and their outcome was determined. The data was analyzed using SPSS-13, t- test, receiver operating characteristics (ROC) and area under curve (AUC) and relative risk (RR). Results: Of total 215 infants, 64 infants (29.7%) died in the hospital and one infant (0.4%) died after discharging from the hospital. 150 (68.8%) infants, were alive at 3 months age follow up. The mean of CRIB- II score in the group of dead infants was higher and statistically significant compared to the group of alive infants (PLow birth weight infantMortalityNewborn Intensive Care UnitsPremature infant2016040115831589http://ijp.mums.ac.ir/article_6656_54c9bc769a03c7167d4d7084b66a798f.pdf2016-04-0110.22038International Journal of Pediatricsijp ; Int J Pediatr2345-50472345-5047201644Increases of Obesity and Overweight in Children: an Alarm for Parents and PolicymakersGholam HasanKhadaeeMasumehSaeidiChildhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low- and middle-income countries, particularly in urban settings. The prevalence has increased at an alarming rate. Globally, in 2013 the number of overweight children under the age of five years old, is estimated to be over 42 million. Close to 31 million of these are living in developing countries. In the WHO African Region alone the number of overweight or obese children increased from 4 to 9 million over the same period. The vast majority of overweight or obese children live in developing countries, where the rate of increase has been more than 30% higher than that of developed countries. If current trends continue the number of overweight or obese infants and young children globally will increase to 70 million by 2025. Without intervention, obese infants and young children will likely continue to be obese during childhood, adolescence and adulthood. Overweight and obesity are largely preventable. Supportive policies, environments, schools and communities are fundamental in shaping parents’ and children’s choices, making the healthier choice of foods and regular physical activity the easiest choice (accessible, available and affordable), and therefore preventing obesity.ChildrenObesityOverweightWorld Health Organization2016040115911601http://ijp.mums.ac.ir/article_6677_1957473e771f40fdba86aadd7311034c.pdf2016-04-0110.22038International Journal of Pediatricsijp ; Int J Pediatr2345-50472345-5047201644The Effect of Distraction Technique on the Pain of Dressing Change among 3-6 Year-old ChildrenSimaKaheniMohammadSadegh RezaiMasoumehBagheri-NesamiAmir HosseinGoudarzianBackground Burn dressings, debridement, surgical incisions, skin grafting and physical therapy are some of painful treatments of burn. According to the studies, distraction techniques have a significant effect on patients’ pain. The present study was designed and conducted to determine the effect of distraction on pain of dressing change in second degree burn in 3-6 year-old children. Materials and Methods This randomized controlled trial study, was conducted on 80 hospitalized children with second degree burn in 2015. Playing a video computer game for children during the dressing change procedure was the intervention for the interventional group. Also the intensity of pain was measured by behavioral pain scale for children (FLCC scale) during dressing. This scale was completed for patients without no intervention in the control group during dressing. Results Pain intensity mean in the interventional group (2.575 ± 1.807) had significant changes in comparison with the control group (8.025 ± 1.187) (PBurnsChildrenDistractionpain2016040116031610http://ijp.mums.ac.ir/article_6699_54b321fedd9302a43ce53253b6115a47.pdf2016-04-0110.22038International Journal of Pediatricsijp ; Int J Pediatr2345-50472345-5047201644Effects of Vitamins K in Neonates and Young InfantsGian MariaPacificiVitamin K is required for the hepatic production of blood coagulation factors II, VII, IX and X. The term vitamin K refers to a variety of fat-soluble 2-methyl-1, 4-naphthoquinone derivatives. Vitamin K1 (phylloquinone) occurs in green plants, while vitamin K2 (menaquinone) is synthesized by microbial in the gut. The recommended dose of vitamin K in neonates is 1 mg intramuscularly. For infants below 2.5 kg, the dose is 0.3 mg/kg to a maximum dose of 1 mg. Vitamin K crosses the placenta poorly, and neonates are relatively deficient of vitamin K at birth. Human milk contains about 1.5 µg/l of vitamin K, whereas most formula milks contain about three times as much as this. Vitamin K1 prophylaxis with 0.2 mg administered intramuscularly maintains adequate vitamin K1 status of preterm infants until a median age of 25 postnatal days and did not cause early vitamin K1 2, 3-epoxide accumulation. There is need for intramuscularly vitamin K prophylaxis for all newborns in order to eradicate hemorrhagic disease of the newborn. Some authors found that the antenatal administration of vitamin K1 to pregnant women in preterm delivery increases the blood coagulation activity in neonates whereas other authors found that the antennal administration of vitamin K1 has no effects on neonates. Vitamin K1 crosses the placenta poorly and it is not surprising that vitamin K1 has limited effects on neonates. The aim of this study was to review the effects of vitamins K in neonates and young infants.EffectsNeonatesVitamin KVitamin K12016040116111624http://ijp.mums.ac.ir/article_6609_9bead196be3716f392d6b9bc46572a92.pdf2016-04-0110.22038International Journal of Pediatricsijp ; Int J Pediatr2345-50472345-5047201644Comparison between BMI and Inverted BMI in Evaluating Metabolic Risk and Body Composition in Iranian ChildrenForoughSakiGholamhosseinRanjbar Omrani2MohammadDabbaghmaneshObjectives: To compare BMI and inverted BMI in evaluating body measurement, resting blood pressure, Dual energy X-ray absorptiometry (DEXA) parameters of fat mass and metabolic risk factors in Iranian children Materials and Methods: This is a cross-sectional study on 477 children aged 9-18 yearsin the South of Iran. Weight, height, resting blood pressure, waist and hip circumference and pubertal stage of all participants was measured with standard methods. DEXA was used to determine body composition index. Blood samples were checked for serum lipid profiles and fasting blood sugar (FBS). Metabolic risk score (MRS) was calculated by the summation of the Z-scores for TC, TG/HDL, LDL, systolic blood pressure, and waist circumference minus HDL Z-score. Results: BMI did not have a normal distribution in our participants but iBMI had a normal distribution. IBMI had more significant correlation with waist to hip ratio and systolic blood pressure (r2=0.053 and r2=0.182) than BMI (r2=0.041 and r2=0.101). MRS had a positive correlation with BMI (PAnthropometryBody Mass IndexChildrenInverted BMI2016040116251636http://ijp.mums.ac.ir/article_6636_13a208326c8fcf624d5a16265a8e14ff.pdf2016-04-0110.22038International Journal of Pediatricsijp ; Int J Pediatr2345-50472345-5047201644Survey of the Use of X-ray Beam Collimator and Shielding Tools during Infant Chest RadiographyVahidKaramiMansourZabihzadehAbdolrezaGilavandNasimShamsBackground The use of shielding tools and X-ray beam collimator has extensively been advocated as effective methods to reduce radiation exposure to patients underwent radiological procedures. The aim of this study was to address the use of these protection measures during infant chest radiography. Material and Methods 348digital and/or analogue infant chest radiographs were reviewed that performed between October- and December 2015 at four main hospitals of Khuzestan-Iran province to assessment the beam collimation. For each radiograph the area between current and acceptable collimation was calculated. Thirty eight radiographers were deeply interviewed to investigate the actual use of shielding tools and the main reasons for not using of them. Results Only 54 (15.5%) radiographs [33(61%) analogues and 21(39%) digital] have satisfactory collimation. The total means area of diagnostic interest (ADI) and the region outside ADI for each radiograph was estimated 171 and 86 cm2, respectively. The irradiated region outside the ADI was significantly larger in digital than in analogue images (mean of 103 cm2 vs. 54 cm2; P < 0.05). Shielding tools were used regularly only by 5% of radiographers. Conclusion The radiosensitive organs of infants located outside of ADI in hospitals investigated are at risk. Adherence to safety guideline urgently recommends.Beam collimationChest radiographyInfantShielding tools2016040116371642http://ijp.mums.ac.ir/article_6708_368e80eee5b509e2ca9cd4ca4d757b3b.pdf2016-04-0110.22038International Journal of Pediatricsijp ; Int J Pediatr2345-50472345-5047201644Malnutrition among HIV- infected Children by Anthropometric Measures in Poor Outreach Area of a Developing Country and its Relationship with CD4 CountsRituRakholiaMeharBanoVineetaRawatBackground: Diagnosis and management of malnutrition in HIV- infected children is important as it is both a manifestation as well as an independent risk factor for death. Extent in hilly poor outreach areas of North India has been poorly studied. Aim: to study the prevalence of malnutrition among children with HIV/AIDS using WHO z- score and Indian Academy of Pediatrics (IAP) method and effect of malnutrition on immune status.
Material and Methods: Setting-Antiretroviral (ART) Centre of a teaching medical college in Uttarakhand-India. Anthropometric measurements (weight, height) and CD4 counts were taken on registration and follow up and duly recorded. Data analysis was done using SPSS -18 and WHO z- score value was calculated using WHO AntroPlus software.
Result: A total of 107 children ( 67 male and 40 female) were studied with mean age of 7.15years.Valid z- score could be calculated only for 46 children and it showed stunting in 69.8%(30/43), wasting in 22.4%(10/46), underweight in 58.9%(27/46). Using IAP method 75% (81/107) had PEM, 85.5% (93/107) stunting. There was no difference between male and female (P>0.05) and no relation between CD4 count and nutritional status (P>0.05). Single dose nevirapine used earlier for Prevention of Parent to Child Transmission (PPTCT) used in 10 newborns resulted in 3/10 HIV negative, 3/10 positive, 4/10 deaths at 18 months.
Conclusion: Malnutrition is rampant in children with HIV/AIDS in hilly poor Outreach areas of India. Chronic malnutrition or stunting was the most common abnormality seen in three fourth of all the children. Hence sensitizing health care workers for timely recognition and prompt remedial measures (ART, nutritional interventions) are need of the hour to reduce mortality and prevent growth failure. It also provides baseline data of efficacy of single dose nevirapine to compare efficacy of newer regimes in prevention of PPTCT. CD4 countsChildrenHIVMalnutritionUnder-weight2016040116431654http://ijp.mums.ac.ir/article_6717_b61f254d27b7e496477946d0c4417115.pdf2016-04-0110.22038International Journal of Pediatricsijp ; Int J Pediatr2345-50472345-5047201644Population Attributable Risk of Unintentional Poisoning in Iranian ChildrenErfanAyubiKamyarMansoriHamidSooriSalmanKhazaeiAliGholamiAbdolhalimRajabiFarhadMoradpourBackground: It is introduced that unintentional childhood poisoning can be as result of child home environment and characteristics of parents. This study aimed at quantifying the adjusted population attributable risk percentage of risk factor of unintentional childhood poisoning. Materials and Methods: The hospital based case- control included 140 consecutive poisoned children who admitted to the Loghman Hospital between March 2013 and July 2014 in Tehran- Iran. The cases were matched with 280 control based on age (within a calliper of six month), gender, and date of hospital attendance. A standardized questionnaire including characterises of unintentional poisoning and its risk factors was completed in a structured interview for cases and controls. We estimated the adjusted odds ratios (OR) and population attributable risks (PAR) of unintentional childhood poisoning, PAR is proportion of poisoning that could have been avoided by the intervention on the modifiable risk factors. Results: Narcotic poisoning was most common type of poisoning among cases (58.6%) and among them accidental methanol ingestion was most (74.7%). The adjusted PARs for lack of attention to labels of poisoning products and availability to them were 54% and 41% respectively, also these figures for children with addicted parents and paternal smoking were 57% and 54% for, respectively. Conclusion: Children with addicted parents were more vulnerable for unintentional poisoning. For substantial reduction of unintentional poisoning, the preventive interventions should focus on modification of child's home environment, improvement of safety behaviours and health literacy of parents, especially in addicted parents.ChildrenEpidemiologic methodsPARPoisoningRisk Factors2016040116551662http://ijp.mums.ac.ir/article_6673_0bb93ebbb205fcc323851415a833e6ab.pdf2016-04-0110.22038International Journal of Pediatricsijp ; Int J Pediatr2345-50472345-5047201644Investigating the Impact of Schools' Open Space on Learning and Educational Achievement of Elementary StudentsAbdolrezaGilavandFatemehEspidkarMohammadrezaGilavandBackground It is obvious that most of informal learnings of social skills and constructive plays occur in school yards and play-fields where children spend much of their non-official time of teaching. This study aimed to investigate the impact of schools' open space on learning and educational achievement of elementary students in Ahvaz, Southwest of Iran. Materials and Methods At a cross-sectional study, 210 students were selected randomly as sample of study. Data collection tools included Hermance’s achievement motivation questionnaire and researcher-constructed questionnaire (observation checklist to examine the physical parameters of learning schools' open space) and interviews with students. Data of study were analyzed in SPSS- 21 software. Results Results of this study showed that schools' open space has a significant impact on learning and academic achievement of elementary school students in Ahvaz- Iran (PEducational achievementLearningSchoolsStudents2016040116631670http://ijp.mums.ac.ir/article_6672_975ec0b47be80a9b1742faa461967cf2.pdf